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<br />1. Living Room <br /> <br />For each numbered item, check one box only. <br /> <br />- <br /> Decision <br />Item Description > If Failor <br /> w 'w If Fail, what repairs are necessary? Inconclusive, <br />No, w <br /> rn ~ <br /> "- '" U If Inconclusive. give details. dale (mm/ddlyyyy) <br /> u. c <br /> .,; 0 0 If Pass with comments, give details. of final approval <br /> ~ u <br /> Z c <br />1.1 living Room Present DD <br />Is there a living room? <br />1.2 Electricity <br />Are there at least two working outlets or one working DDD <br />outlet and one working light fixture? <br />1.3 Electrical Hazards <br />Is the room free from electrical hazards? DDD <br />1.4 Security <br />Are all windows and doors that are accessible from <br />the outside lockable? DD <br />1,5 Window Condition <br />Is there at least one window, and are all windows <br />free of signs of severe deterioration or missing or DD <br />broken out panes? <br />1.6 Ceiling Condition <br />Is the ceiling sound and free from hazardous defects? DD <br />1.7 Wall Condition <br />Are the walls sound and free from hazardous defects? DD <br />1.8 Floor Condition <br />Is the floor sound and free from hazardous defects? DD <br />1.9 Lead-Based Paint <br />Are all painted surfaces free of deteriorated paint? DD <br />If no, does deteriorated surfaces exceed two square DD D Not Applicable <br />feet and/or more than 10% of a component? <br /> <br />Additional Comments: (Give Item Number) <br /> <br />Comments continued on a separate page Yes 0 <br /> <br />No D <br /> <br />Previous editions are obsolete <br /> <br />Page 3 of 20 <br /> <br />form HUD.52580-A (9/12000) <br />ref Handbook 7420.8 <br />